PA-Breastfeeding Coalition Minutes, July 26 2006

PABC Meeting Minutes
July 26th, 2006
Fredrickson Center, Harrisburg

Attendance: Jeanne Spencer, Kathy Romberger, Shelly Lebo, Ruth Solomon, Kathie Wagner, Pat Keister, Wendy Shore, Ruth Wilf, Chris Mulford, MaryAnn Mihok, Helen Vermilya, Dawn Blanchard, Kay Hoover, Cynthia Bartok, Shannon Lilienthal, Leslie Cree, Martha Kautz, Barb Shocker, Karen Campbell.

I. Call To Order- The meeting was called to order by coalition chairman, Dr. Jeanne Spencer, at 1010.

II. Treasurer’s Report- The treasurer’s report was given by coalition treasurer, Kathy Romberger.

A. Items to note include an uncashed check cut to Mr. Mark Deluca for website work. Discussion began regarding the lack of website activity for almost one year. It was decided that if no progress is made by September 1, 2006, the coalition will start over with website design, content and employ a new webmaster. Kay Hoover reported her daughter-in-law is willing to help. Leslie Cree mentioned she will ask her computer-savvy neighbor.
B. Kathy also passed around membership renewal envelopes requesting all those able should please renew during the meeting in the absence of Rosa Snyder-Boyd, membership.

III. Old Business

A. Future meeting dates
1. The next meeting will be held on October 18th in State College at the brand new breastfeeding clinic on the edge of main campus. (Our old location has been bulldozed- so sad to see it go!) Directions from the old location: Business Route 322 to Atherton Street. From North Atherton Street, Turn right onto White Course Dr. (2nd right after light at Park Ave.) From South Atherton, turn left onto White Course Dr. Once on White Course Dr., proceed to the 1st stop sign beside the ticket booth for a parking pass “for PABC members.” Park in the lot and walk to the signal light at Atherton and White Course Dr. Cross Atherton and turn right and enter through the double glass doors off Atherton into the Elmore Clinical Research Wing of the Noll Laboratory Building (the 1st building on your left). Once inside, we are meeting in Seminar Room #127.
2. January 24th 2007 -Bridge Call from 12 to 2pm. Call in number is: 814-863-2330.
3. April 25th 2007 in Somerset at the same location just off the turnpike. Possible name change from Ramada to Quality Inn? [Rosa please confirm and report to Jeanne.]
4. July 18th 2007 returning to Harrisburg and the Fredrickson Center
B. Skype.com- Ruth Wilf introduced the group to this computer-based, telephone long-distance service. It is a free download from the website and costs 2 cents per minute across the globe with free calls to fellow “skype” users.

IV. New Business

A. Strategic Planning for PABC- Mary Ann M. suggested we do a “S.W.O.T.” analysis via email critiquing our bylaws, mission statement, etc. (S= strengths, W=weaknesses, O=opportunities, and T=threats)
B. Request from the State DoH – Martha asked the group if we would like to work with them in a collaborative partnership, endorsing each other and helping whenever necessary to extend our reach in advocacy and disseminating accurate information. A sort of “blessing” that could be a financial advantage for future projects as well as a unified example for other states without breastfeeding awareness programs and coalitions at the state level. They would like to have a model breastfeeding policy available on their website (currently under construction to include pages specific to breastfeeding). Since PABC has done this in the past, better to collaborate than “re-invent the wheel.” We all agreed.
C. Elections were due for the Chair and Vice-Chair, being the July meeting of an even year. Since presently seated people had not yet met their term limits, Jeanne and Wendy will maintain their positions as Chair and Vice Chair respectively. The April meeting in Somerset will generate a nominating committee for candidates for Secretary and Treasurer, whose terms are up in July 2007. Elections for these positions will take place next year at the Harrisburg/July meeting.
D. State Initiation Rates- a map with rates listed by county was circulated by Martha. The numbers were obtained from the state’s birth certificates. Amazingly, there are only 121 birthing hospitals left in PA and this number is decreasing as hospitals merge their services regionally.
E. DME info- speaking for Tracy Brown from Medela who was unable to attend, Martha Kautz briefly explained where the Dept of Public Welfare is in their process of covering breast pumps for mothers on Medicaid in PA. She reviewed an 18 page “work statement” highlighting the following points:
1. More details are available on the website
2. 92% of 10 counties in the southwestern and 16 counties in the south central and southeastern areas of the state are already covered with specific HMO’s and their DME’s. The rest of the state will be covered by 3 main DME providers, with subcontractors permitted.
3. Verbage of the difference between breast pumps:
E0602= “breast pumps, all types” (this means a manual pump)
E0603= “breast pumps, electric, AC/DC or any type” (this could be anything from a Mag Mag to a Mini-electric, it is not specified)
E0604= “breast pumps, heavy duty, hospital grade, with provisions” (this requires a prior authorization or a prescription) This is the one we all want. There is some uncertainty whether the pumps will be rental or for purchase. What is being done now and what will be in the future, of course, cannot be known at this time.
4. Tracy asks that we all get used to saying, “hospital grade” and E0604 and listen in your local areas for who may be getting these contracts and share with the group.
5. When this goes into effect, any mother using a pump from a DME that is NOT one of the 3 main contactors, will have to return that pump and obtain a new prescription for a pump from one of the 3 preferred providers.
6. Verbage that Tracy questioned in tesetimony:
a. “timely manner”- needs defined, we would prefer pumps be delivered within 24 hours of the request, may require subcontracting when distance is an issue.
b. “sufficient inventory”- who determines this? this may mean subcontractors may carry different sized flanges but the main provider only carries the pumps? What brand and how much?
c. “industry norms”- who determines what these are and has the authority to police it? (PABC?)
d. “train on appropriate use, set up, (etc)“- who will do this? Train the staff and train the client receiving the pump? Could coalition members across the state help?
e. “quality and appropriate pump”- What is this exactly and who determines this? Is E0604 a Pump In Style or a Lactina rental and for how long, for what reasons?
f. The last public meeting on this topic was July 24th, but they may accept letters until ? [Someone needs to find this out for us!!]
g. Jeanne suggests Tracy draft a letter, addressing all these issues, for all of us to print out and sign and send. Jeanne will thank her for all her hard work and ask her about a letter. We all thank Tracy for all the hard work she has put into this issue as a concerned citizen, mother, and member of our coalition!! Thank You!
F. Proclamation from the Governor –3 originals obtained by Barb Shocker, (Thank you, Barb!) Cynthia Bartok will scan an original into her computer and it will be sent out to all of us to print and circulate.
G. Domperidone- Jeanne initiated discussion about what is going on across the state.
1. Ephrata, Lancaster, Philadelphia, and York areas are seeing usage with clients.
2. Legal ramifications for the physician are Jeanne’s major concern should the unthinkable sudden cardiac death side effect occur. Any thoughts?
3. FDA has not approved it for any use in the US, yet it is not an “illegal” substance.
4. Thomas Hale’s book says it is safer than reglan and lots of other things we use. The Hartmann/Hale conference in Virginia in the fall may address this topic. Watch for details if this affects your practice.
H. PA State Statistics- Martha Kautz
1. Only 121 birthing hospitals in the state!
2. abc27news.com story circulated about breastfeeding in public
3. MCM journal for July/August 2006 has 2 articles of note:
a. Dawn’s fatty acid article (she spoke to us about this last April in Somerset)
b. Diane Spatz’s article
c. MCM Vol.31, No. 4, page 224.
4. Mini Grants-
a. Application period for ‘06-’07 is closed.
b. Grants starting on January 1, 2007 and thereafter, will run the calendar year til December 31st.
c. Applications for ’07-’08 will be available in October, if not before.
5. An email to Martha, with little explanation, circulated. Governor’s Task Force on Obesity requesting information on existing grants related to their cause? Look for more info from Jeanne in your email.
6. P.A.D.O.H. FINALLY got a pump room in the building!! This has been a lot of work for Martha trying to convince her employers to support the associates who work within the building the same way they are supposedly advocating for in publications and with the creation of her job and the awareness program. Yeah, Martha!! Not official til fall- red tape!!!
7. The breastfeeding “department” is trying to mesh WIC and non-WIC publications. Martha and Cyndi Maki are working on it.
8. Martha asked for a copy of the model hospital policy to post on the state’s website as soon as it is ready. Kay and Mary Ann to look for a copy. Martha would like to use it on site inspections in the future.
9. Martha asked the group’s opinion on sharing credit for a poster to be sold to others outside the state. Martha had a few at her booth at ILCA and could have sold lots more! Is this a fundraising opportunity or should it be given away across the state? Or both? Discussion around free vs. cost of printing and shipping. Results of the voiced opinions was not clear. Kay and Cynthia agreed to research shipping and printing costs.
10. There was a Mother’s Day Rally in King of Prussia on May 12th, 2006 featuring Senator Connie Williams in support of breastfeeding. Photos of the event were circulated. Medela and Maternity Care Coalition sponsored the rally. Good job to all!

V. Sharing

A. Jeanne Spencer, Conemaugh Hospital-
1. Her local coalition is distributing car magnets and paid for a radio PSA which we all listened to. Good job!!
2. New pertussis combined with tetanus vaccine (Tdap) available for adults and preferred for health care workers, especially if it has been 2-5 years since your last tetanus booster.
B. Barb Shocker, Hershey-
1. Introduced new coworker, Karen Campbell, who is a 0.5 lactation professional in their NICU.
2. October 5th, 2006 will be their one day conference featuring Diane Spatz and a NICU nutritionist.
3. The two-day conference is scheduled for sometime in April 2007.
4. World Breastfeeding Week activities planned for this year include bulletin board decorations throughout the hospital celebrating the working mother and showing pictures of employee’s breastfed children, certificates for the mothers that week and isolette tags thanking mothers for breastfeeding their babies. They also plan to recognize resource nurses across the system for their support of breastfeeding both inpatient and outpatient, etc.
C. Martha Kautz, Dept of Health and Ephrata Hospital-
1. “Little Baby Bellies” informational sheet circulated. Email her for a copy.
2. In Ephrata, new manager, NICU difficulties with physicians.
D. Shannon Lilienthal, Harrisburg Hospital, mother, IBCLC- new member to the group, has an 8- week-old son (exclusively breastfed, of course!) with a type 3 tongue tie (that we all found very interesting, thanks for sharing!). She comes from a full time IBCLC position with Pennsylvania Hospital in Philly and is now going to teach prenatal breastfeeding classes for Kathy in Harrisburg and is still looking for something else very part-time. Welcome, Shannon!
E. Dr. Cynthia Bartok, Penn State- the new clinic is OPEN!!! Yeah!
1. Kay Hoover has been hired as the clinician and research projects are being set up, clients are being seen, and we will have a chance to tour the facility at our October meeting.
2. The staff is also in negotiations with IBLCE regarding academics and IBCLC pathways.
F. Kay Hoover, Penn State –
1. showed us the new research from Donna Ramsey and Peter Hartmann’s team regarding the recently discovered and published work on the NEW anatomy of the breast via the Medela interactive CD-ROM released at ILCA 2 weeks ago.
2. Talked briefly how exciting it is to be at Penn State and be working in the new clinic.
G. Dawn Blanchard, Williamsport-
1. wrote a frenulotomy article, looking for a publisher
2. spurred a retired physician to revisit the clipping of tongue tied infants and he is now teaching new residents to perform the procedure
3. fatty acid article published in MCM this month
4. local billboard campaign spun off into bus ads
H. Helen Vermilya- WBW activities include lecture for family practice residents and certificates to breastfeeding mothers and staff advocates
I. Mary Ann Mihok- still enjoying retirement
J. Chris Mulford, Pro-LC-
1. Pro-LC sponsored the ILCA conference in Philly 2 weeks ago, went well
2. WBW activities- contest among local hospitals for the best WBW display
K. Ruth Wilf-
1. 70% initiation rate at PA Hospital, no follow-up for duration rates
2. recently joined the CIMS Board and briefly explained the Mother-Friendly Initiative which outlines 10 points, of which #10 is BFHI. More info at motherfriendly.org
3. recently joined the US Breastfeeding Committee
L. Wendy Shore, Memorial Hospital- recent gastric bypass patient’s milk samples will be evaluated
at the new clinic in Penn State in October.
M. Pat Keister, York Hospital-
1. T. Hale may speak at York Hospital in the fall
2. Using Medela diaper bag tags and magnets with clients
N. Kathie Wagner, Nursing Mothers Counselors-
1. analyzing outcomes with peer counselors
2. WBW picnic for volunteers
O. Ruth Solomon, LLL-
1. Regional Conference in Reading on October 21st , 50th Anniversary year for LLL this year! Kay Hoover speaking.
2. WBW “walks” around the area
P. Shelly Lebo, Harrisburg Hospital NICU- new to the group, Welcome!!
Q. Kathy Romberger, Harrisburg Hospital-
1. Happy to have Shelly in NICU and Shannon teaching classes
2. Breastfeeding Education Day August 2nd, Kay Hoover speaking
3. Birth rate about 5000 and IBCLC’s still doing home health visits!!

VI. Committee reports

A. Public Policy
1. Senator Williams’ bills are either tabled or ‘in committee’. Shannon L.’s husband works on the Senate floor and will notify us when relevant topics arise in the future via Shannon. Thanks!! (Always helpful to have someone on the INside!!)
2. Would like to communicate with the people who update the state’s hospital regulations in hopes of affecting change within the hospital through them.
B. Public Relations
1. Newsletter to be resurrected with a new format. “Highlight a Member” and “Ask a Doc” sections suggested for columns. May be strictly pdf/email format or written or both.
C. Provider Education
1. Working on the frenulotomy issue, a document or statement or article in the process, including benefits, reimbursement, how and when to do it and when NOT to do it.
2. Insurance company coverage issue- only 1 responded to their survey, would like to partner with “the state” (AKA Martha) in working through the state’s insurance commissioners or insurance department.
D. Research Committee- did not meet, members needed to attend other committees.

Respectfully Submitted,

Wendy Shore RN, IBCLC
“Note –taker” (in Nellie’s absence)